Method for modulation of effector organs

• US 9,707,391 B2
• Filed: 06/22/2016
• Issued: 07/18/2017
• Est. Priority Date: 12/22/2013
• Status: Active Grant

• Current Assignee: City College of New York
• Original Assignee: City College of New York
• Inventors: Ahmed, Zaghloul
• Primary Examiner(s): VOORHEES, CATHERINE M
• Application Number:
  US15/190,088
• Publication Number:
  US 20160339238A1
• Time in Patent Office: 391 Days
• CPC Class Codes: A61F 7/08 Warming pads, pans or mats A61F7/02 takes precedence; Hot-water bottles
• CPC Class Codes: A61F 7/10 Cooling bags, e.g. ice-bags
• CPC Class Codes: A61N 1/0551 Spinal or peripheral nerve electrodes
• CPC Class Codes: A61N 1/20 continuous direct currents
• CPC Class Codes: A61N 1/205 for promoting a biological process
• CPC Class Codes: A61N 1/36003 of motor muscles, e.g. for walking assistance
• CPC Class Codes: A61N 1/3616 Voltage density or current density

Abstract

Modulation of target effector organs in vertebrate beings using direct current stimulation for stimulation of spinal cord at regions of autonomic innervation, using direct current for peripheral nerve stimulation, by modulating central autonomic outflow and combinations thereof.

Claims

1. A method for modulating activity of an autonomically-innervated effector organ in a vertebrate being, the method comprising the steps of:

identifying a spinal circuit between a spinal location and a return location of a vertebrate being, said spinal location associated with spinal efferent neural outflow to an autonomically-innervated effector organ of interest of said being; and

delivering non-varying, constant direct current to said spinal circuit between said spinal location and said return location for effecting trans-spinal direct current stimulation of said efferent neural outflow to modulate activity of said organ; and

applying a second direct current to a nerve providing neural control of at least one muscle associated with said organ;

wherein the activity of said organ is bladder function;

wherein modulating said bladder function is for treating a condition selected from the group consisting of urinary retention and urinary incontinence; and

wherein said treating urinary incontinence comprises anodal trans-spinal direct current stimulation at a spinal level of S2-S4 to decrease parasympathetic tone and said nerve is selected from the group consisting of pelvic splanchnic nerve and pudendal nerve.

2. The method of claim 1, further comprising:

modulating central autonomic outflow of said being to said spinal location to affect said spinal outflow.

3. The method of claim 1, further comprising:

modulating central autonomic outflow to said spinal location to affect said spinal outflow.

4. The method of claim 1, wherein the activity of said organ is bladder function.

5. The method of claim 4, wherein said modulating of spinal outflow is associated with modulation of said bladder function for treating a condition selected from the group consisting of urinary retention and urinary incontinence.

6. The method of claim 5, wherein the efferent neural outflow to the bladder is selected from the group consisting of sympathetic and parasympathetic activity.

7. The method of claim 5, wherein said treating urinary incontinence comprises anodal trans-spinal direct current stimulation at a spinal level of S2-S4 to decrease parasympathetic tone.

8. The method of claim 5, wherein said treating urinary retention comprises cathodal trans-spinal direct current stimulation at a spinal level of S2-S4 to increase parasympathetic tone.

9. The method of claim 5 wherein said treating urinary incontinence comprises cathodal trans-spinal direct current stimulation at a spinal level of T11-L2 to increase sympathetic tone.

10. The method of claim 5, wherein said treating urinary retention comprises anodal trans-spinal direct current stimulation at a spinal level of T11-L2 to decrease sympathetic tone.

11. The method of claim 1, wherein said trans-spinal direct current stimulation is applied using skin surface electrodes.

12. The method of claim 1, wherein said trans-spinal direct current stimulation is applied using at least one implanted electrode.

13. The method of claim 1, wherein said treating urinary retention comprises cathodal trans-spinal direct current stimulation at a spinal level of S2-S4 to increase parasympathetic tone and said nerve is selected from the group consisting of pelvic splanchnic nerve and pudendal nerve.

14. The method of claim 1, wherein said treating urinary incontinence comprises cathodal trans-spinal direct current stimulation at a spinal level of T11-L2 to increase sympathetic tone and said nerve is selected from the group consisting of pelvic splanchnic nerve and pudendal nerve.

15. The method of claim 1, wherein said treating urinary retention comprises anodal trans-spinal direct current stimulation at a spinal level of T11-L2 to decrease sympathetic tone and said nerve is selected from the group consisting of pelvic splanchnic nerve and pudendal nerve.

16. The method of claim 1, wherein said trans-spinal direct current is applied using skin surface electrodes and said second direct current is applied using implanted electrodes.

17. The method of claim 2, wherein the activity of said organ is bladder function;

and wherein modulating bladder function is applied for treating a condition selected from the set of urinary retention and urinary incontinence.

18. The method of claim 17, wherein said treating urinary retention comprises cathodal trans-spinal direct current stimulation at a spinal level of S2-S4 to increase parasympathetic tone, said nerve is selected from the group consisting of pelvic splanchnic nerve and pudendal nerve, wherein said second direct current is pulsed, and said modulating central autonomic outflow includes application of at least one of the group consisting of transcranial direct current stimulation, transcranial magnetic stimulation, transcutaneous vagal nerve stimulation, application of heat to a thermosensitive area of skin, and administering a parasympathomimetic pharmacological agent.

19. The method of claim 17, wherein said treating urinary incontinence comprises cathodal trans-spinal direct current stimulation at a spinal level of T11-L2 to increase sympathetic tone, said nerve is selected from the group consisting of pelvic splanchnic nerve and pudendal nerve, wherein said second direct current is pulsed, and said modulating central autonomic outflow includes application of at least one of the group consisting of transcranial direct current stimulation, transcranial magnetic stimulation, application of cold to a thermosensitive area of skin, and administering a sympathomimetic pharmacological agent.

20. The method of claim 17, wherein said treating urinary retention comprises anodal trans-spinal direct current stimulation at a spinal level of T11-L2 to decrease sympathetic tone, said nerve is selected from the group consisting of pelvic splanchnic nerve and pudendal nerve, wherein said second direct current is pulsed, and said modulating central autonomic outflow includes application of at least one of the group consisting of transcranial direct current stimulation, transcranial magnetic stimulation, application of heat to a thermosensitive area of skin, transcutaneous vagal nerve stimulation, and administering a sympatholytic pharmacological agent.

21. The method of claim 3, wherein the activity of said organ is bladder function;

and wherein modulating bladder function is for treating a condition selected from the group consisting of urinary retention and urinary incontinence.

22. The method of claim 21, wherein said treating urinary incontinence comprises anodal trans-spinal direct current stimulation at a spinal level of S2-S4 to decrease parasympathetic tone and said modulating central autonomic outflow includes application of at least one of the group consisting of transcranial direct current stimulation, transcranial magnetic stimulation, application of cold to a thermosensitive area of skin, and administering a parasympatholytic pharmacological agent.

23. The method of claim 21, wherein said treating urinary retention comprises cathodal trans-spinal direct current stimulation at a spinal level of S2-S4 to increase parasympathetic tone and said modulating central autonomic outflow includes application of at least one of the group consisting of transcranial direct current stimulation, transcranial magnetic stimulation, transcutaneous vagal nerve stimulation, application of heat to a thermosensitive area of skin, and administering a parasympathomimetic pharmacological agent.

24. The method of claim 21, wherein said treating urinary incontinence comprises cathodal trans-spinal direct current stimulation at a spinal level of T11-L2 to increase sympathetic tone and said modulating central autonomic outflow includes application of at least one of the group consisting of transcranial direct current stimulation, transcranial magnetic stimulation, application of cold to a thermosensitive area of skin, and administering a sympathomimetic pharmacological agent.

25. The method of claim 21, wherein said treating urinary retention comprises anodal trans-spinal direct current stimulation at a spinal level of T11-L2 to decrease sympathetic tone and said modulating central autonomic outflow includes application of at least one of the group consisting of transcranial direct current stimulation, transcranial magnetic stimulation, application of heat to a thermosensitive area of skin, transcutaneous vagal nerve stimulation, and administering a sympatholytic pharmacological agent.

26. A method for modulating activity of an autonomically-innervated effector organ in a vertebrate being, the method comprising the steps of:

identifying a spinal circuit between a spinal location and a return location of a vertebrate being, said spinal location associated with spinal efferent neural outflow to an autonomically-innervated effector organ of interest of said being;

delivering non-varying, constant direct current to said spinal circuit between said spinal location and said return location for effecting trans-spinal direct current stimulation of said efferent neural outflow to modulate activity of said organ; and

modulating central autonomic outflow of said being to said spinal location to affect said spinal outflow;

wherein the activity of said organ is bladder function; and

wherein modulating bladder function is applied for treating a condition selected from the set of urinary retention and urinary incontinence; and

wherein said treating urinary incontinence comprises anodal trans-spinal direct current stimulation at a spinal level of S2-S4 to decrease parasympathetic tone, said nerve is selected from the group consisting of pelvic splanchnic nerve and pudendal nerve, wherein said second direct current is pulsed, and said modulating central autonomic outflow includes application of at least one of the group consisting of transcranial direct current stimulation, transcranial magnetic stimulation, application of cold to a thermosensitive area of skin, and administering a parasympatholytic pharmacological agent.